| Entity Name: | PHYSICIAN ON CALL, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 23 Aug 2006 (18 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | L06000083257 |
| FEI/EIN Number | 205420916 |
| Address: | 850 NW FEDERAL HWY 152, STUART, FL, 34994 |
| Mail Address: | 3756 SW BIMINI CIR S, PALM CITY, FL, 34990 |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649456443 | 2008-01-11 | 2008-01-11 | 3756 SW BIMINI CIR S, PALM CITY, FL, 349901335, US | 850 NW FEDERAL HWY, SUITE 151, STUART, FL, 349941000, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 772-403-5860 |
| Fax | 7727812680 |
Authorized person
| Name | DR. WALTER R GIL |
| Role | OWNER |
| Phone | 7724035860 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME0050565 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME98874 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUE CROSS FLORIDA |
| Number | 07303 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GIL WALTER R | Agent | 3756 SW BIMINI CIR SOUTH, PALM CITY, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| GIL WALTER R | Manager | 850 NW FEDERAL HWY 152, STUART, FL, 34994 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CANCEL ADM DISS/REV | 2008-10-03 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-10-03 | 850 NW FEDERAL HWY 152, STUART, FL 34994 | No data |
| CHANGE OF MAILING ADDRESS | 2008-10-03 | 850 NW FEDERAL HWY 152, STUART, FL 34994 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-10-03 | 3756 SW BIMINI CIR SOUTH, PALM CITY, FL 34990 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2008-10-03 |
| Florida Limited Liability | 2006-08-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
